Heart Care | Abnormal Heart Rhythm | Pediatric Pacemaker Procedure

Pacemakers are most often needed for children with a type of arrhythmia in which heart rhythms are too slow. It is a device that follows your child's heart beat and makes sure it doesn't fall below a certain rate. The procedure to implant a pacemaker usually requires a 24-hour hospital stay.

We recommend that you contact our Child Life Services department to help prepare your child for his or her hospital experience. By preparing your child for the procedure and listening to your child's feelings, you can help your child know what to expect and lessen his or her fears.

A general anesthesia will be given to your child so he or she can't eat or drink anything for eight hours before the pacemaker surgery. Your doctor will tell you exactly when your child should stop eating solid foods and drinking clear liquids. It is extremely important that your child have an empty stomach before receiving sedation for the procedure.

If your child appears ill, has a fever, cold, cough, vomiting, diarrhea, diaper rash or has recently been exposed to chicken pox, the pacemaker procedure may be postponed. Please call your doctor's office prior to the scheduled procedure date to discuss any symptoms your child may have.

Before the procedure, a nurse will check your child's temperature, pulse rate and blood pressure and will give your child pajamas to wear while in the hospital.

Sedation will be given to your child before and during the pacemaker surgery. During the pacemaker implantation, you will be given a pager so that we can easily reach you.

Depending on your child's age, size and the type of pacemaker to be implanted, the procedure will be done either in the operating room or in a special laboratory with X-ray cameras. The pacemaker procedure usually takes four to six hours.

All of the people in the room will be dressed in scrub suits, masks and hats. The area where the pacemaker will be implanted — either the chest or abdomen — will be washed with a yellow antiseptic soap. Your child will be covered with sterile drapes. He or she will have general anesthesia to insure comfort. In addition, the doctor will inject a local anesthetic to numb the area where the pacemaker will be implanted. Nurses and doctors will closely monitor your child at all times.

The pacemaker is made of two main parts — the leads and the generator. The leads are thin wires that connect the heart with the generator. The leads can be attached to the surface of the heart or passed through a vein inside the heart. The lead is then attached to the generator. The generator is a small metal case that includes a battery and a microcomputer, which is the "brain" of the pacemaker. The generator is sutured under the skin in the upper chest or abdomen.

At the end of the procedure, sutures are placed under the skin to seal the wound and a dressing placed over the wound. The sutures will be absorbed as the wound heals.

After the pacemaker is implanted, your child will return to his or her room and may feel sleepy for several hours. He or she will be asked to lie in bed for four to six hours. When awake, your child can drink clear liquids and later have something to eat. In most cases, your child will return home the following morning.

Prior to leaving the hospital, you'll receive a temporary identification card that contains important information about the model and serial number of your child's pacemaker. Within six months, you'll receive a permanent card in the mail from the pacemaker manufacturer. This card should be kept with you and your child at all times.

Before you and your child go home, please make sure you receive the following materials from your child’s doctor or nurse:

Please adhere to the following instructions to ensure your child has a smooth recovery.

Your child's dressing may be removed the following day after he or she return home. Beneath the dressing are small pieces of tape, called steri-strips. These will fall off in one to two weeks. Absorbable sutures are located beneath the skin and do not need to be removed.

The best treatment is to keep the wound clean and dry. No ointments or creams should be used. Sponge baths are allowed, but the pacemaker site should be kept dry. Two weeks after the procedure, your child will be allowed to shower.

Although your child will be given antibiotics during and after the procedure, it is important to watch for signs of infection. These signs include redness, swelling, increased pain, drainage or fever. If these occur, please notify your child's doctor immediately.

Limit your child's sports activities for four to six weeks while healing. For pacemakers implanted in the chest, your child must avoid lifting his or her arm over the head on the side where the pacemaker is implanted for two to four weeks.

Before leaving the hospital, ask your child's doctor or nurse specific questions related to your child's activities.

Microwave ovens and other appliances that are in good repair will not interfere with your child's pacemaker. Computers, hair dryers, power tools, radios, televisions, stereos, electric blankets and cars also won't interfere with a pacemaker.

A few things, however, might cause interference. These include very strong magnets such as those used for MRI scans, heavy-duty electrical equipment such as arc welders and certain surgical instruments.

Pacemakers may set off a metal detector, such as those at airports. When traveling, your child may need to show a pacemaker identification card to security personnel.

Digital cell phones are unlikely to interfere with pacemaker function but avoid holding them directly over your child's pacemaker.

Your child's first follow-up appointment should occur one to two weeks after the procedure. This appointment should be made with the Pediatric Heart Center at UCSF Children's Hospital or with your referring physician.

At the clinic appointment, the doctor and nurse will examine your child's wound and check the pacing thresholds. This is the energy needed to safely pace the heart. We encourage you to ask any questions you or your child may have concerning pacemakers.

To make a follow-up appointment, please call:
Pediatric Heart Center (415) 353-2008

Please state that your child needs a pacemaker follow-up appointment. The pacemaker clinic is held one day per week and is located at:

Pediatric Heart Center
400 Parnassus Ave.
Second Floor, Room A-2962
San Francisco, CA 94143

This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.